Problem Wounds: Paw Reconstruction

Traumatic injuries of the distal limbs and feet are common in small animals. When the damage is extensive-including injury to the extensor tendons, ligaments, and joint capsules-the wounds should be allowed to heal by second intention until a granulation bed develops. This allows development of the fibrous connective tissue to stabilize the joints and provide support. Some of the affected digits may need to be amputated if pain and instability persist. Digits 3 and 4 are the primary weight-bearing digits and should be preserved if at all possible. Lacerations and small skin defects may be closed with sutures. Skin flaps or skin grafts can be used if extensive pressure is present. Foot pad injuries require special attention to prevent chronic lameness. If possible, lacerations should be sutured to ensure that the edges of the foot pads are well apposed. When necrosis of the feet of dogs has occurred, amputation is necessary. For indoor cats with carpeted houses, the end of the foot can be resurfaced using a pouch flap or skin graft. Full-Day Wound Healing Symposium

COMMENTARY: The techniques described for salvage of the pads are relatively high risk in terms of the final outcome. Because they entail sacrifice of the first and/or fifth digit to allow the digital foot pad to be used to reconstruct the metacarpal or metatarsal pad, there is some risk if the procedure fails; in these cases the animal should be sent to a specialist for further evaluation and treatment.